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Sarah Malaba

Sarah Malaba

Co-CEO of Tiko, an African non-profit improving adolescent girls' health across Sub-Saharan Africa; veteran public health leader based in Nairobi.

Jun 12, 2026

4:13
Can you actually talk, Sarah, about the triple threat? What does it mean and how it fits into the siloed system? And who actually has the power, accountability, responsibility to break that open? And what's stopping not doing that?
4:33
Yeah, so the triple threat, as far as TIKO is concerned, and most of the African governments, when you talk about the triple threat to the lives of girls, it talks about the three interconnected but dangerous threats that collectively account for the highest number of disease, the highest number of deaths, and the highest number of disability among adolescent girls and young women in sub-Saharan Africa.
4:57
And the three really around unintended pregnancy, new HIV infections, and sexual violence.
5:05
So those three in the past, in terms of addressing them, were addressed in a silo, because that's how funding and the health structuring was done in terms of services delivery.
5:16
But today we say that if we're to win the war against unintended pregnancy, which continues to persist, and more than three quarters of new HIV infections take place among adolescent girls of 15 to 24 years, we need to actually address the pervasive issue around sexual violence, which is really the biggest driver of unintended pregnancy and HIV.
5:38
In that sense, then, they cannot be addressed in a silo.
5:41
They need to be addressed collectively.

7 MINS LATER

13:00
So it's not only just adding girls into the maternal health agenda, adding girls to the HIV agenda, adding girls into the GBV agenda, but there has to be a clear line of health financing that actually goes beyond health financing it it also include social accountability in so many perspectives so what can move action so how the actual financing into into girls can happen in take your own government or what do you think needs to happen

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